Association between Phthalate Exposure and Frailty among Community-Dwelling Older Adults: A Repeated Panel Data Study

Only a few studies have examined the impacts of environmental exposure on frailty. This study investigated the association between phthalates and frailty among community-dwelling older adults. The Korean Elderly Environmental Panel II (KEEP II) study is a repeated panel data study of 800 community-dwelling older adults in South Korea. Frailty was measured with five items defined by Fried and colleagues. Environmental pollutants in the form of two types of metabolites for Di-ethylhexyl phthalate (DEHPs)—Mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and Mono (2-ethyl-5-oxohexyl) phthalate (MEOHP)—were obtained from urine specimens. Analyses were performed using repeated linear mixed models. The concentration levels of both MEOHP and MEHHP in urine were significantly higher in the pre-frail or frail group than its counterparts. While adjusting for covariates, MEOHP level was positively associated with the likelihood of being pre-frail or frail in both males and females; the concentration level of MEHHP also had a positive impact on the likelihood of being pre-frail or frail in females. The DEHP metabolite concentrations were significantly lower among adults with daily fruit consumption in both males and females. DEHPs, measured by metabolite concentrations, may increase the risk of frailty among older men and women; further studies are necessary. The preventive effects of nutrition on DEHP risk should also be further investigated.

Download Full-text

Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis

Innovation in Aging ◽

10.1093/geroni/igab046.3253 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 904-904

Author(s):

Christina Prevett ◽

Kevin Moncion ◽

Stuart Phillips ◽

Julie Richardson ◽

Ada Tang

Keyword(s):

Older Adults ◽

Resistance Training ◽

Physical Function ◽

Gait Speed ◽

Positive Impact ◽

Community Dwelling ◽

Mobility Disability ◽

Exercise Interventions ◽

Walking Capacity ◽

Community Dwelling Older Adults

Abstract Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.

Download Full-text

Medication Review in Preventing Older Adults’ Fall-Related Injury: a Systematic Review & Meta-Analysis

Canadian Geriatrics Journal ◽

10.5770/cgj.24.478 ◽

2021 ◽

Vol 24 (3) ◽

pp. 237-250

Author(s):

Yu Ming ◽

Aleksandra A. Zecevic ◽

Susan W. Hunter ◽

Wenxin Miao ◽

Rommel G. Tirona

Keyword(s):

Systematic Review ◽

Older Adults ◽

Medication Review ◽

Positive Impact ◽

Data Extraction ◽

Meta Analysis ◽

Risk Difference ◽

Community Dwelling ◽

Randomized Controlled Studies ◽

Community Dwelling Older Adults

Background Medication review is essential in managing adverse drug reactions and improving drug safety in older adults. This systematic review evaluated medication review’s role as a single intervention or combined with other interventions in preventing fall-related injuries in older adults. Methods Electronic databases search was conducted in PubMed, EMBASE, Scopus, and CINAHL. Two reviewers screened titles and abstracts, reviewed full texts, and performed data extraction and risk of bias assessment. Meta-analyses were conducted on studies with similar participants, interventions, outcomes or settings. Results Fourteen randomized, controlled studies were included. The pooled results indicated that medication review as a stand-alone intervention was effective in preventing fall-related injuries in community-dwelling older adults (Risk Difference [RD] = -0.06, 95% CI: [-0.11, -0.00], I2 = 61%, p = .04). Medication review also had a positive impact on decreasing the risk of fall-related fractures (RD = -0.02, 95% CI: [-0.04, -0.01], I2 = 0%, p = .01). Discussion This systematic review and meta-analysis has demonstrated that medication review is effective in preventing fall-related injuries in general, and fractures specifically, in community-dwelling older adults. Future investigations focusing on the process of performing medication review will further inform fall-related injury prevention for older adults.

Download Full-text

Associations of social isolation, social participation, and loneliness with frailty in older adults in Singapore: a panel data analysis

BMC Geriatrics ◽

10.1186/s12877-021-02745-2 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Lixia Ge ◽

Chun Wei Yap ◽

Bee Hoon Heng

Keyword(s):

Older Adults ◽

Panel Data ◽

Confidence Interval ◽

Social Isolation ◽

Social Participation ◽

Odds Ratio ◽

Fixed Effects ◽

Moderating Effect ◽

Community Dwelling ◽

Community Dwelling Older Adults

Abstract Background There is a shortage of research evidence about how social isolation, social participation, and loneliness were longitudinally associated with frailty. This study was to 1) examine the associations of social isolation, social participation, and loneliness with level of frailty among community-dwelling older adults using panel data, and 2) explore the moderating effect of gender on the association of social isolation, social participation and loneliness with frailty. Methods The study included 606 participants aged 60 years and above from the longitudinal Population Health Index Survey conducted in Singapore. At each timepoint, level of frailty was determined using the Clinical Frailty Scale. Social isolation was assessed by the Lubben Social Network Scale-6, and loneliness was assessed using the three-item UCLA Loneliness Scale. Fixed-effects ordinal logistic regressions were conducted with level of frailty as the dependent variable and social isolation and loneliness as the independent variables, adjusting for time-varying socio-demographic, lifestyle, and health-related factors. Results Increase in social participation was associated with lower level of frailty (odds ratio: 0.96, 95% confidence interval: 0.93–0.99) and feeling lonely was associated with higher level of frailty (odds ratio: 2.90, 95% confidence interval: 1.44–5.84). Social isolation was not associated with frailty. Gender did not have moderating effect on these associations. Conclusions This study observed that social isolation and loneliness had differential longitudinal association with level of frailty among community-dwelling older adults and suggested that loneliness and frailty should be measured and addressed concurrently among community-dwelling older adults.

Download Full-text

Association Between Physical Exercise and Cognitive Function Among Community-Dwelling Older Adults

Journal of Applied Gerontology ◽

10.1177/0733464820952242 ◽

2020 ◽

pp. 073346482095224

Author(s):

Yohannes Endeshaw ◽

Felicia Goldstein

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Physical Exercise ◽

Positive Impact ◽

Secondary Data ◽

Community Dwelling ◽

Clock Drawing Test ◽

Current Events ◽

Normal Cognitive Function ◽

Community Dwelling Older Adults

Objectives: To examine the association between self-reported physical exercise and cognitive function. Design: Secondary data analysis of a prospective cohort study. Participants: Community-dwelling older adults with normal cognitive function at baseline. Measurements: Data on self-reported physical exercise, immediate and delayed recall, clock drawing test, and orientation to time and current events were collected at baseline and annual follow-up visits. Generalized estimation equation method was used to determine the association between physical exercise and decline in cognitive function. Results: A total of 4,227 participants were included in the analysis, 58% women, 78% White, mean (SD) age 75.7 (7.1) years. The risk of cognitive decline was lower among those who reported moderate-to-high intensity exercise (odds ratio [OR] confidence interval [CI] = 0.45 [0.20, 0.69]; p < .001) and low-intensity exercise (OR [CI] = 0.62 [0.44, 0.83]). Conclusion: These results reaffirm the positive impact of physical exercise in maintaining cognitive function among older adults.

Download Full-text